Vesicoureteral Reflux -- Child

Definition

Vesicoureteral reflux (VUR) is the backward flow of urine. The urine flows from the bladder back into the kidneys.

Urine normally flows out from the kidneys. It passes through tubes called ureters. It then flows into the bladder. Each ureter connects to the bladder in a way that prevents urine from flowing back up the ureter. This connection is similar to a one-way valve. When this does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up to the kidney. If the urine contains bacteria, the kidney may become infected. The back-up can also put extra pressure on the kidney. This can cause kidney damage.

This is a potentially serious condition. It requires care from a doctor. Early treatment and prevention of infections can lead to better outcomes.

Treatment

The goal for treatment of VUR is to prevent any permanent kidney damage. Treatment options include:

Monitoring

Treatment may not be needed right away for grades 1-3. VUR may go away on its own as the ureters develop. The doctor will monitor your child’s condition. This may include:

Antibiotics—If an infection is present or possible.

Tests to check how the kidneys are functioning

Children are advised to stay well-hydrated by drinking plenty of fluids. They should also empty their bladders frequently.

Surgery

In most cases, surgery is not needed. If your child does need surgery, the options include:

Ureteral reimplantation surgery—This can be done in two ways. One requires making an incision above the pubic bone and repositioning the ureters in the bladder. It can also be done laparoscopically, with cameras being inserted through small incisions in the abdomen and/or bladder to do the surgery.

Endoscopic injection into the ureter—This is a minimally invasive surgery that is done to correct the reflux. A gel is injected where the ureter inserts into the bladder. This can block urine from flowing back up the ureter.

Prevention

VUR cannot be prevented in most cases. Avoid complications by getting prompt treatment. If you suspect a urinary tract or kidney infection, call your child's doctor.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.